Emergency Department Wait Time Commission 
Please submit any related informational links or documents you would like to share with the Commission through this collection form. Responses will be uploaded to HSCRC's webpage on a weekly basis. 
Sign in to Google to save your progress. Learn more
Email *
Name and Organization
Link Submission
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of State of Maryland.

Does this form look suspicious? Report